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Managing feeding difficulties and behaviours in food allergic children

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Issues at mealtime are just one of four factors that can affect feeding difficulties in young children

A feeding difficulty is a broad term to describe a variety of feeding or mealtime behaviours perceived as problematic for a child or family. This includes: picky/ fussy eating (limited variety of food), food refusal and inability to eat (as is seen with oral motor and swallowing difficulties); food fads/ pica (focus on specific foods/ non-foods); food neophobia (fear of new food which starts around two years of age); food or taste aversion (repulsed by taste, often associated with a past illness involving vomiting); limited, variable or excessive appetites; slow eating and prolonged mealtimes; no interest in food; delay in self-feeding and disruptive mealtime behaviours.

How common are feeding difficulties?

Feeding problems are estimated to affect 25-50% of normally developing infants and young children.1,2 Higher rates are reported in children with developmental delay and chronic illness (33-80%) and it has long been recognised that multiple food allergies are a risk for feeding difficulties.1,2

Early recognition is important to prevent simple feeding problems from becoming pervasive and resistant to treatment, which can result in adverse effects on nutritional status and growth, development and psychological outcomes.1,2 The severity of feeding difficulty increases the younger the age of onset and the longer the duration of the feeding problem.

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